OBR Peer-Spectives
Peer-Spectives is a podcast series that is moderated by Robert Figlin, MD, and features various oncology thought-leaders covering the latest clinical developments in a wide range of tumor types.
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Oncologist Shortage “Has Gotten to the Crisis Level”
05/06/2024
Oncologist Shortage “Has Gotten to the Crisis Level”
Especially in rural areas, the growing oncologist shortage has “gotten to crisis level,” says Harsha Vyas, MD, president and founding partner of Cancer Center of Middle Georgia in Dublin. “We just don’t have enough supply of medical oncologists/hematologists,” he tells Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles. Dr. Vyas puts forth his ideas for potential solutions, ranging from medical school debt repayment to congressional intervention. As Dr. Figlin notes, “we need to rethink” current approaches because there’s a “storm” on the horizon and “we’re all seeing it coming.” Dr. Vyas reported no relevant financial relationships. Dr. Figlin reported various financial relationships.
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“Monster Improvements” in CLL Care Prompt Questions About BTK Inhibitor Use
04/16/2024
“Monster Improvements” in CLL Care Prompt Questions About BTK Inhibitor Use
The development of noncovalent Bruton tyrosine kinase (BTK) inhibitors and other advances in chronic lymphocytic leukemia treatment signify that the “future is really exciting,” says Jennifer A. Woyach, MD, professor in the Division of Hematology at The Ohio State University in Columbus. Dr. Woyach speaks with Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles, about the potential of moving these new drugs into the frontline setting and other questions related to BTK inhibitor resistance. Dr. Woyach reported various financial relationships. Dr. Figlin reported various financial relationships.
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“Better to Have Choices”: How New Data Transform EGFR-Mutated NSCLC Care
03/29/2024
“Better to Have Choices”: How New Data Transform EGFR-Mutated NSCLC Care
Given recent data, how should oncologists choose a tyrosine kinase inhibitor (TKI) in patients with EGFR-mutated non-small cell lung cancer (NSCLC), and when should chemotherapy be introduced? “It’s better to have choices than not,” explains , the Dudley Chair in Cancer Research at the University of Colorado in Aurora. Dr. Bunn discusses how recent trials influence treatment decisions in NSCLC with , the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer Center in Los Angeles. Dr. Bunn stresses why molecular testing is so crucial and previews what additional findings are likely to further change practice in patients with EGFR-mutated NSCLC.
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Practice-Changing Data Introduce “Whole New Challenge” in Prostate Cancer
03/26/2024
Practice-Changing Data Introduce “Whole New Challenge” in Prostate Cancer
The treatment of biochemical recurrence in prostate cancer “is set for rapid development over the next few years,” says , medical director of the Center for Uro-Oncology Research Excellence at the Samuel Oschin Comprehensive Cancer Center at Cedars-Sinai Medical Center. Data from the recent EMBARK trial have changed practice for the treatment of men with high-risk features. Dr. Posadas discusses these findings and related advances with , the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer Center in Los Angeles. They also consider how the growing role of prostate-specific membrane antigen (PMSA) positron emission tomography (PET)-CT is “really impacting” care for patients with prostate cancer who have biochemical recurrence. Dr. Posadas explains why the best approach for patients with negative PSMA PET-CT results who have high-risk features remains “a point of great discussion.”
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FDA Approval for TIL Therapy “Real Milestone” That Has Been “Long Time Coming”
03/21/2024
FDA Approval for TIL Therapy “Real Milestone” That Has Been “Long Time Coming”
The U.S. Food and Drug Administration’s recent accelerated approval of a tumor-infiltrating lymphocyte therapy in metastatic melanoma “is a real milestone,” after the approach was “pending for decades,” explains , deputy director at the NYU Langone Perlmutter Cancer Center. Dr. Weber, who was part of the team to first work with the treatment in the late 1980s, discusses the breakthrough with , the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer Center in Los Angeles. They examine what this accelerated approval means for practice and consider the "incredibly expensive cost” associated with the treatment. They also consider the evolving role of high-dose interleukin-2 in this patient population.
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From “Fairytale” to Reality? Paradigm Shift in Bladder Cancer Care
03/08/2024
From “Fairytale” to Reality? Paradigm Shift in Bladder Cancer Care
Recent advances in metastatic urothelial carcinoma have meant that optimistic outcomes are “not as much of a fairytale,” says Robert Dreicer, MD, deputy director of the UVA Cancer Center and professor of medicine and urology at the University of Virginia School of Medicine in Charlottesville. From the recent approval of enfortumab vedotin plus pembrolizumab to other key findings recently presented at the American Society of Clinical Oncology Genitourinary Cancers Symposium, Dr. Dreicer discusses “paradigm-shifting” advances with Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer Center in Los Angeles. Dr. Dreicer explains the “deal-breaker” that renders one treatment strategy “a relative no-brainer” for certain patients, as well as what upcoming data are likely to change practice even more.
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FDA Approvals, Pivotal Trial Data Change Approach to Breast Cancer Progression
02/14/2024
FDA Approvals, Pivotal Trial Data Change Approach to Breast Cancer Progression
Recent approvals by the U.S. Food and Drug Administration (FDA) and findings from pivotal clinical trials have changed care for patients with breast cancer that has progressed after frontline hormone therapy. , chair of medicine and Charles H. Dewey Professor at the University of Rochester in New York, highlights which recent developments regarding second- and third-line treatments are most essential. She and , the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer Center in Los Angeles, discuss which newly approved drugs are making a difference in patients with actionable mutations, as well as those without. Dr. O’Regan also details which soon-to-be reported studies she is awaiting in 2024.
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Controversies, Difficult Questions Arise in NSCLC Amid New Data
02/14/2024
Controversies, Difficult Questions Arise in NSCLC Amid New Data
Recent data on the use of immunotherapy and targeted treatments in patients with advanced non-small cell lung cancer (NSCLC) have introduced a myriad of questions. These include controversial topics and difficult decisions, like when to incorporate CTLA-4 inhibition and what patients can expect from immuno-oncology monotherapy in the metastatic setting. , professor in the department of medicine in hematology/oncology and director of the thoracic oncology program at the Jonsson Comprehensive Cancer Center at the University of California Los Angeles, discusses key challenges in NSCLC care with , the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer Center in Los Angeles. From optimal strategies in second-line settings to promising clinical trials, Dr. Garon shares how he applies emerging information in practice.
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What FDA Approval of Belzutifan Means for Kidney Cancer Care
02/05/2024
What FDA Approval of Belzutifan Means for Kidney Cancer Care
Belzutifan was by the U.S. Food and Drug Administration (FDA) for use in previously treated adults with advanced renal cell carcinoma. How should this drug best be incorporated into practice? , professor in the Department of Genitourinary Medical Oncology at the University of Texas MD Anderson Cancer Center in Houston, and , the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer Center in Los Angeles, discuss how the medication might be used in clinic. Dr. Jonasch also provides insight into the , which led to the FDA approval, as well as other ongoing trials that may further change the landscape of kidney cancer care.
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Despite Lack of Head-to-Head Trials, Practice Patterns Shifting in Breast Cancer
02/01/2024
Despite Lack of Head-to-Head Trials, Practice Patterns Shifting in Breast Cancer
CDK4/6 inhibitors “have really been a game changer” in metastatic breast cancer, according to , clinical director for early drug development and section head for endocrine therapy research at Memorial Sloan Kettering in New York City. However, optimal treatment strategies have been complicated by a lack of head-to-head trials. Dr. Jhaveri speaks with , the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer Center in Los Angeles, about how “practice patterns have slightly shifted” despite challenges in assessing efficacy across regimens and approaches. Dr. Jhaveri also discusses her work on the , which found a benefit in adding a PI3K inhibitor to the combination of CDK4/6 inhibitors and hormone therapy. The trial reported a “monstrously important clinical hazard ratio,” according to Dr. Figlin, and may help clarify best practices moving forward.
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Which FDA Approvals, Other Advances Changed ER-Positive Breast Cancer Care in 2023?
12/18/2023
Which FDA Approvals, Other Advances Changed ER-Positive Breast Cancer Care in 2023?
From presented at the to the recent U.S. Food and Drug Administration , 2023 saw numerous key advances in breast cancer care. , director of the breast cancer research program at Massachusetts General Hospital and associate professor at Harvard Medical School in Boston, and , the Steven Spielberg Family Chair in hematology-oncology at Cedars-Sinai Cancer Center in Los Angeles, discuss how several notable developments are already impacting practice. Dr. Bardia explains why genotyping is essential, provided it is available and affordable, and what recent changes have meant for the “roadmap” he presents to patients with metastatic disease. He also considers what 2024 may have on tap for this rapidly changing field.
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“New Disruptor” in Prostate Cancer: PSMA PET and Other Treatment Advances
12/15/2023
“New Disruptor” in Prostate Cancer: PSMA PET and Other Treatment Advances
From the use of prostate-specific membrane antigen (PSMA) positron-emission tomography (PET) to advancements in targeted treatments, prostate cancer care is quickly evolving. , director of the Experimental Therapeutics Program and director of the Center for Urologic Oncology Research Excellence at Cedars-Sinai in Los Angeles, speaks with , the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai, about how he is already implementing promising new data into practice. Although Dr. Posadas notes that although immunotherapy approaches in prostate cancer have been “a bit of a disappointment” so far, he sees “a lot of exciting research going on.” He explains why he doesn’t “like to wait” when expanding his therapeutic armamentarium and why he prefers to be “proactive rather than reactive” when it comes to molecular profiling and other approaches.
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Practice-Changing Results in Prostate Cancer, as Enzalutamide Regimens Show Strong Benefit
12/14/2023
Practice-Changing Results in Prostate Cancer, as Enzalutamide Regimens Show Strong Benefit
Results of the recent show that both enzalutamide plus leuprolide and enzalutamide monotherapy significantly improved metastasis-free survival compared with leuprolide alone in patients with prostate cancer who have high-risk biochemical recurrence. Lead author , associate director for education and training and director of the Center for Integrated Research in Cancer and Lifestyle at Cedars-Sinai Cancer Center in Los Angeles, speaks with , the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai, about how these findings should be applied in practice. Although the data represent a significant advance, Dr. Freedland suggests even more progress ahead, asking "This is the new standard, but for those [who] are really high-risk, how can we do even better?”
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ER-Positive Breast Cancer Advances and Other Eagerly Anticipated Data at SABCS 2023
11/20/2023
ER-Positive Breast Cancer Advances and Other Eagerly Anticipated Data at SABCS 2023
Studies involving high-risk, early-stage ER-positive breast cancer are among the most eagerly anticipated at this year’s , to be held Dec. 5-9. , professor of medicine in the division of hematology and medical oncology at the University of Texas Health Sciences Center San Antonio and leader of the breast cancer program at the Mays Cancer Center, discusses which data she thinks has the best chance of changing practice soon. She also speaks with , the Steven Spielberg Family Chair in hematology-oncology at Cedars-Sinai Cancer Center in Los Angeles, about key research into HER2-positive disease, brain metastases, and local therapy to watch for at this year’s conference.
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Inside ODAC’s Vote on Sotorasib in Advanced and Metastatic NSCLC: Lessons Learned
11/15/2023
Inside ODAC’s Vote on Sotorasib in Advanced and Metastatic NSCLC: Lessons Learned
Last month, a U.S. Food and Drug Administration (FDA) Oncologic Drugs Advisory Committee (ODAC) determined that progression-free survival (PFS) could not be reliably interpreted in a confirmatory clinical trial for sotorasib (Lumakras) used to treat KRAS G12C–mutated locally advanced or metastatic non-small cell lung cancer (NSCLC). , senior clinician at the National Cancer Institute’s Center for Cancer Research and chair of the ODAC, speaks with , the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer Center in Los Angeles, about broader implications from the 2-10 vote against the sotorasib data. They discuss the specific rationale behind the decision, as well as what this means for clinical practice in the short term and big picture solutions to help improve future trials.
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First-Line Osimertinib Plus Chemo in NSCLC: How to Weigh Toxicity vs. Efficacy
11/07/2023
First-Line Osimertinib Plus Chemo in NSCLC: How to Weigh Toxicity vs. Efficacy
How should results of the be applied in practice? The study examined the use of osimertinib plus chemotherapy in the first-line treatment of EGFR-mutated advanced non-small cell lung cancer (NSCLC) compared with osimertinib alone and found that progression-free survival was significantly improved with the combination treatment. , director of three cancer centers at the Dana-Farber Cancer Institute in Boston, including the Lowe Center for Thoracic Oncology, shares his team’s findings with , the Steven Spielberg Family Chair in hematology-oncology at Cedars-Sinai Cancer Center in Los Angeles. They discuss toxicity concerns, best practices for treatment assessment, and how to identify patients for whom the new strategy may yield the best results.
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What Recent “Outstanding Results” in MCL Mean for Practice
10/27/2023
What Recent “Outstanding Results” in MCL Mean for Practice
“Therapies are improving dramatically” in mantle cell lymphoma (MCL), according to Michael Wang, MD, professor in the department of lymphoma/myeloma, division of cancer medicine at the University of Texas MD Anderson Cancer Center in Houston. Dr. Wang presented updates on major advances in MCL at the recent Society of Hematologic Oncology (SOHO) annual meeting. Here, he speaks with Bob Figlin, MD, the Steven Spielberg family chair in hematology-oncology at Cedars-Sinai Cancer Center in Los Angeles, about which promising regimens from recent studies are most appropriate for certain age groups. Dr. Wang and Dr. Figlin also discuss common challenges when approaching newly diagnosed patients, as well as how to process the “explosion” of new information in MCL.
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The Quest to Cure CLL: “Remarkable” Results With New Strategy
09/06/2023
The Quest to Cure CLL: “Remarkable” Results With New Strategy
Recent advances have provided new options for when and how best to treat patients with chronic lymphocytic leukemia (CLL). Trials of combination strategies have shown promise in providing patients the potential for unmaintained remissions. , an assistant professor of medicine in hematology-oncology at the Perlman School of Medicine at the University of Pennsylvania and scientific director of the lymphoma program, speaks with , the Steven Spielberg Family Chair in hematology-oncology at Cedars-Sinai Cancer Center in Los Angeles, about the current state of CLL care and what changes are likely in the near future. Although satisfied in many ways with recent progress, Dr. Ruella argues in favor of moving past simply “maintaining the disease at long-term” and, instead, pushing for a cure. Dr. Ruella reports relationships with AbClon, BMS, Bayer, NanoString, and UPenn/Novartis. has reported relationships with numerous companies.
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Which Data From the 2023 World Conference on Lung Cancer Are Most Likely to Change Practice?
08/15/2023
Which Data From the 2023 World Conference on Lung Cancer Are Most Likely to Change Practice?
The World Conference on Lung Cancer (World Lung) will be held in Singapore, September 9–12. The current president of International Association for the Study of Lung Cancer (IASLC), Heather A. Wakelee, MD, division chief of medical oncology at the Stanford Cancer Institute in California, shares which presentations and findings she is most looking forward to at this year’s event. She speaks with Robert Figlin, MD, the Steven Spielberg Family Chair in hematology-oncology at Cedars-Sinai Cancer Center in Los Angeles, about steps being taken to ensure that key information from the conference is communicated quickly, clearly, and effectively to community oncologists around the world. They also discuss specific issues that will be addressed in Singapore, including a focus on lung cancer screening and why overcoming obstacles to more widespread uptake is crucial.
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“Really Impactful” New Guidelines for Stage IV NSCLC With Driver Alterations
08/03/2023
“Really Impactful” New Guidelines for Stage IV NSCLC With Driver Alterations
Updates to the American Society for Clinical Oncology’s (ASCO’s) living guidelines for therapy in patients with stage IV non-small cell lung cancer (NSCLC) with driver alterations were recently released. Dwight H. Owen, MD, MS, from The Ohio State University Comprehensive Cancer Center – James, examines the new recommendations that he and his team introduced with Bob Figlin, MD, the Steven Spielberg family chair in hematology-oncology at Cedars-Sinai Cancer Center in Los Angeles. They discuss how the living guidelines are updated and the rationale for what gets included, a process Dr. Figlin notes is “critical to the practicing oncologist.” Dr. Owen describes three new additions that are “really impactful” and his hopes for how these will directly improve patient care.
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More “Cage Rattling,” Less Talking: Susan Love’s Lessons for Oncologists
07/18/2023
More “Cage Rattling,” Less Talking: Susan Love’s Lessons for Oncologists
In early July, beloved surgeon and breast cancer advocate Susan Love, MD, MBA, died at age 75 years, after a recurrence of leukemia. Dr. Love’s legacy extends beyond the lives of her patients and into the approaches and attitudes of her fellow physicians. Stephanie Graff, MD, medical advisor to the Dr. Susan Love Foundation for Breast Cancer Research and director of breast oncology at the Legorreta Cancer Center at Brown University in Providence, Rhode Island, shares memories and insights about Dr. Love with Bob Figlin, MD, the Steven Spielberg Family Chair in hematology-oncology at Cedars-Sinai Cancer in Los Angeles. They discuss why talking less, listening more, and “rattling” the right cages are key lessons oncologists can take away from “a giant in cancer care” and mentor, who is already sorely missed.
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Will HER3 Targeting Change Breast Cancer Care?
06/27/2023
Will HER3 Targeting Change Breast Cancer Care?
HER2 inhibitors dramatically changed care for many breast cancers; however, less is known about HER3, which acts in concert with HER2. Does HER3 have the same potential to reshape treatment strategies? Erika Hamilton, MD, director of breast cancer and gynecologic cancer research at Sarah Cannon Research Institute in Nashville, talks with Bob Figlin, MD, the Steven Spielberg family chair in hematology-oncology at Cedars-Sinai Cancer Center in Los Angeles, about HER3, how it works, and how new antibody-drug conjugates (ADCs) that target HER3 are already showing activity in hard-to-treat disease. She also explains how sequencing ADC therapies may work and what other changes could be next.
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“Practice-Expanding” Data on Adjuvant Osimertinib in NSCLC: Steps to Take Now
06/26/2023
“Practice-Expanding” Data on Adjuvant Osimertinib in NSCLC: Steps to Take Now
Although findings have suggested that adjuvant osimertinib is beneficial in early-stage non-smallcell lung cancer (NSCLC), some concerns have persisted. Balazs Halmos, MD, MS, associate director of clinical science, and director of both thoracic oncology and clinical cancer genomics at Montefiore Einstein Cancer Center in New York, says that “all these doubts have been shifted away,” given recent data presented at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting. Dr. Halmos speaks with Bob Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer in Los Angeles, about data from the ADAURA trial and other studies. Dr. Halmos says that the new evidence is “not just practice-affirming” butcan be considered “practice-expanding,” resulting in complicated questions that necessitate morethorough collaborations among oncologists, surgeons, pathologists, and radiologists.
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“Don't Just Throw Drugs Together”: How to Best Approach ESR1 Mutations in Breast Cancer
06/20/2023
“Don't Just Throw Drugs Together”: How to Best Approach ESR1 Mutations in Breast Cancer
How should community oncologists best approach ESR1 mutations in breast cancer, given the latest findings? Recent data presented at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting and elsewhere have shed light on issues related to ESR1 testing and treatment selection. Bob Figlin, MD, the Steven Spielberg Family Chair in hematology oncology at Cedars-Sinai Cancer in Los Angeles, speaks with Hope Rugo, MD, professor of medicine in the division of hematology and oncology, department of medicine, and director of breast oncology and clinical trials education at the University of California San Francisco Helen Diller Family Comprehensive Cancer Center, about how to put new findings into practice. Dr. Rugo provides key recommendations, as she explains that “It’s really important that we don’t just throw drugs together in clinical practice.”
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mRNA Cancer Vaccines: When to Expect FDA Approval, and What’s Next?
05/17/2023
mRNA Cancer Vaccines: When to Expect FDA Approval, and What’s Next?
Recent that mRNA vaccination improved recurrence-free survival among patients with melanoma. This has led to questions about what’s next for this promising intervention. , the Steven Spielberg Family Chair in hematology-oncology at Cedars Sinai Cancer in Los Angeles, welcomes , deputy director, professor, and co-director of the melanoma research program at NYU Langone’s Perlmutter Cancer Center, todiscuss potential timing for FDA approval and additional cancers that may see benefit from a vaccine strategy.
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“Major Wins” in Lung Cancer Treatment: How “Explosion of Data” Is Changing Practice
05/09/2023
“Major Wins” in Lung Cancer Treatment: How “Explosion of Data” Is Changing Practice
Within the last few years, an “explosion of data” regarding adjuvant and neoadjuvant treatment for resectable lung cancer has contained “major wins” for patient care. Although exciting, the rapid advancement has led to questions about when chemotherapy and chemoimmunotherapy should be adopted or avoided. Bob Figlin, MD, the Steven Spielberg Family Chair in hematology-oncology at Cedars Sinai Cancer in Los Angeles, and Charu Aggarwal, MD, MPH, the Leslye M. Heisler Associate Professor for Lung Cancer Excellence at the University of Pennsylvania’s Abramson Cancer Center in Philadelphia, discuss how to apply key recent findings. They also share “the special sauce” that allows Dr. Aggarwal’s team to make the best determination for surgical timing.
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“Great Therapies for All-Comers” in CLL: How Can Oncologists “Pick and Choose?”
04/18/2023
“Great Therapies for All-Comers” in CLL: How Can Oncologists “Pick and Choose?”
As treatment options increase for patients with CLL, so do questions about which interventions, if any, are right for which patients and when. Bob Figlin, MD, and Nicole Lamanna, MD, discuss key considerations, ranging from cardiac toxicity to why Dr. Lamanna “won't just treat for a symptom.”
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Pragmatica-Lung Tests a Treatment and a New Approach to Trials
03/17/2023
Pragmatica-Lung Tests a Treatment and a New Approach to Trials
The newly opened Pragmatica-Lung trial compares ramucirumab plus pembrolizumab versus usual care for treatment of stage IV or recurrent non-small cell lung cancer. The trial is designed to ease enrollment requirements and data collection needs, focusing on the key endpoint of overall survival. Listen as study lead Karen Reckamp, MD, professor and division director for Cedar Sinai Cancer and Medical Oncology, and Bob Figlin, MD, the Steven Spielberg Family Chair in hematology oncology at Cedar Sinai Cancer, talk about how the trial came about and why it could change how future studies are done across cancer types
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The Best First Step in Metastatic NSCLC Care
03/10/2023
The Best First Step in Metastatic NSCLC Care
With more than 10 known driver mutations in non-small cell lung cancer (NSCLC), testing is ever more critical, says , division chief of medical oncology at Stanford University and president of the International Association for the Study of Lung Cancer. Listen as she and Peer-Spectives host Bob Figlin, MD, the Steven Spielberg Family Chair in Hematology Oncology at Cedars-Sinai Cancer, talk about how she manages patients with metastatic disease or those who need adjuvant treatment, when she starts targeted therapy or immunotherapy, and more. “We can drastically change the course of disease for a patient by giving them the appropriate targeted treatment. So that testing is so critical,” Dr. Wakelee said.
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Neo- and Adjuvant Treatments Are Changing Care in Early NSCLC
03/06/2023
Neo- and Adjuvant Treatments Are Changing Care in Early NSCLC
Treatment options are expanding quickly in early non-small cell lung cancer. Listen as , division chief of Medical Oncology at Stanford University and president of the International Association for the Study of Lung Cancer, describes how she’s using new agents and incorporating trial findings into practice. She and host Bob Figlin, MD, the Steven Spielberg Family Chair in Hematology Oncology at Cedars-Sinai Cancer, explore the growing roles for neo- and adjuvant therapy and how to select patients for each therapeutic approach.
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